Published: Tuesday, September 10, 2013 at 6:30 a.m.

Last Modified: Monday, September 9, 2013 at 6:08 p.m.

It's been nearly a year since the Heart of Florida Health Center took over the primary health care services for low-income families previously provided by the Marion County Health Department.

Though the partnership has had its glitches along the way, both agencies believe the new system overall has been successful for area patients and the community.

Heart of Florida's patient visits have grown by 70 percent since Oct. 1, the date it took over those primary care services.

It is now planning an expansion, hoping to jump from five locations to at least seven within the next year.

"We're looking at space all over town," said Kerrie Jones Clark, Heart of Florida's chief executive officer. "We will open two over the next year."

Health Department spokesman Craig Ackerman said primary care was just part of the public health mission in Marion County, "although it was one of the most visible services the health department provided at the time."

For the Health Department, the partnership means more time focusing on community health issues, maternity, family planning, Healthy Start and nutritional services.

For both agencies, the past year has been a new adventure in establishing a new identity to the public.

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Heart of Florida began evolving in 2007 with financial support from Munroe Regional Medical Center, Ocala Regional Medical Center, the County Commission and others to care for the area's indigent and uninsured.

The nonprofit emerged from Community Health Services of Marion County, which was designed to get low-income patients needing non-emergency care out of emergency rooms. In 2011, the latest year statistics were available, 24.2 percent of Marion County residents under the age 65 did not have health insurance.

In 2009, the Heart of Florida began growing under a board directors. Heart of Florida is a federally qualified health center, a designation that was needed to pave the way for the Health Department partnership.

Today, the two hospitals continue to share in the operating costs and the Health Department donates the services of a primary care physician, who serves as medical director.

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In 2011 the agency began debating whether the partnership was a good idea.

Heart of Florida officials believed it would be a daunting task, considering a partnership would mean nearly doubling its staff.

Before the partnership, Heart of Florida's patient visits had already grown by 44.7 percent in four years, from 15,000 in 2007-08 to 21,700 in 2011-12.

Since the Heart of Florida board didn't want to rush into the partnership, Clark spent nine months meeting with the Health Department.

Clark and Dr. Nate Grossman, the Health Department director who has since retired, traveled to the Tampa area to look at a similar partnership.

"That's when we decided that it could work," Clark said.

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The partnership meant that Heart of Florida's patient visits would grow from 21,700 in 2011-12 to 38,000 in 2012-13. The number of individual patients grew from 8,680 to 15,200.

Clark said once Heart of Florida committed, it began making appointments for Health Department patients in May 2012 in hopes for a smooth transition.

But the Health Department patients who waited until after Oct. 1 to make appointments found that they couldn't be seen by a doctor until December and January.

Patients complained about the difficulty in securing appointments, though Clark said people needing immediate health care were seen.

Clark said once the appointment issue was straightened out, the arrangement has been running much smoother.

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Last October, Heart of Florida took over about 6,000 square feet of space at the Health Department's Southeast 32nd Avenue location.

Heart of Florida also has locations at the Centers on Southwest 60th Avenue, its Southwest First Avenue site, Reddick and Belleview.

And now, Clark said the agency is looking to soon expand again — possibly to a site near downtown Ocala and another in a more remote area of Marion.

Heart of Florida may open another location if it receives a federal grant to service Marion Oaks and the Florida Highlands area.

"The grant would pay for a site on County Road 484," Clark said.

Clark said the biggest first-year challenges were hiring enough staff in the first few months to keep up with all of the new patients. The other was obtaining viable Internet service at its Reddick facility.

Heart of Florida can provide patients with a variety of services not offered by the Health Department, like chronic-care management to treat diabetes, asthma and heart disease.

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For the Health Department, the hardest part about the partnership was laying off personnel, although many of those affected workers were hired by the Heart of Florida.

Ackerman said now that primary care services are no longer the Health Department's responsibility, the agency will continue to work to protect, promote and improve health in the community.

"Our mission has been in the public eye recently, with the tuberculosis investigation that is still underway, and the fungal meningitis investigation that was in the news in 2012," Ackerman said of the agency's role within the new partnership.

The health agency also joined forces with the Marion County tax collector so that residents can get birth certificates when they go in for driver's license renewals.

"We recently expanded dental services to include women who are in the Healthy Start program," he said.

Contact Joe Callahan at 867-4113 or joe.callahan@starbanner.com. Follow him on Twitter at JoeOcalaNews.

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